QT interval in children and infants receiving cisapride.
OBJECTIVE
Life-threatening arrhythmias and prolonged QT interval have been reported in adults and children using cisapride, a medication structurally similar to procainamide. Premature infants have reduced activity of cytochrome p-450, the system responsible for metabolism of cisapride, which could lead to QT prolongation. Therefore, we prospectively studied premature infants and children receiving cisapride to analyze the effect of prolonged cisapride therapy on QT interval.


METHODS
Premature infants in a neonatal intensive care unit and children seen at a pediatric gastroenterology clinic in a tertiary care hospital had electrocardiography-analyzed and -corrected QT interval measured before cisapride (0.8/mg/kg per day) therapy, and again after 1 month of therapy. If baseline electrocardiography was not performed initially, it was obtained after cessation of therapy.


RESULTS
A total of 30 children participated in the study. Mean corrected QT interval was similar at baseline and at 1 month after therapy. Significant QT prolongation was not found, and no adverse effects were recorded.


CONCLUSIONS
Corrected QT interval during prolonged cisapride therapy at 0.8 mg/kg per day appears to be similar for premature infants and children. An inherent trend toward QT prolongation was not detected in either group. In the absence of other risk factors that alter cisapride metabolism or predispose to arrhythmia, cisapride may be safe for use in premature infants as well as in children. Additional studies are needed to confirm these data.
Levine
A
A
Division of Gastroenterology and Nutrition, the Division of Cardiology, Schneider Children's Medical Center of Israel, Tel Aviv University Sackler School of Medicine, Petah Tikva, Israel.
Fogelman
R
R
Sirota
L
L
Zangen
Z
Z
Shamir
R
R
Dinari
G
G
D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D002648:Child; D020117:Cisapride; D004562:Electrocardiography / Q000187:drug effects*; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005767:Gastrointestinal Diseases / Q000188:drug therapy* / Q000503:physiopathology; D006321:Heart / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D012449:Safety
D005765:Gastrointestinal Agents; D010880:Piperidines; D020117:Cisapride